The Shoulder
The Shoulder
75
Insurancequick-fox-229

Insurance denied my claim with zero explanation — been waiting 4 months, is this even allowed??

I genuinely don't know what to do anymore and I'm hoping someone here has been through something similar.

Back in the spring I got rear-ended at a stoplight. Other driver was clearly at fault — there were two witnesses and a police report. I filed a claim through my own insurance (I carry full coverage including collision) and at first everything seemed fine. Adjuster called me once, I sent in all my photos, the repair estimate, everything they asked for.

Then... silence. Weeks went by. I called and got transferred around. Finally about six weeks in, someone left me a voicemail just saying the claim was "not approved at this time" — no letter, no explanation, no nothing. I've called back probably a dozen times since then and I either get voicemail or someone who says they'll "look into it" and never follows up.

It's been over four months now. My car is still sitting in my driveway with a smashed rear quarter panel. I can't afford to just pay out of pocket and honestly I shouldn't have to — I've been paying premiums on this policy for years without a single claim.

A few specific things I'm confused about:

  • Do insurance companies actually have to tell you why they deny a claim?
  • Is there a time limit on how long they're allowed to drag this out?
  • My deductible is honestly a stretch for me right now — does that factor in at all?

I'm not looking for someone to feel sorry for me, I just want to understand my options. Has anyone actually pushed back on their insurer and gotten somewhere? Or am I just shouting into the void here?

13replies

Not sure what your claim is worth?

AskMatlock can connect you with an independent injury lawyer for a free case check — no pressure, no cost to start.

Check my case

0 / 4000 · posted under a randomly assigned handle

13 replies

  • 19
    patient-wren-838

    A few practical things worth knowing: most states have a Department of Insurance where you can file a complaint against your insurer for bad faith claims handling — and it's free to do. Insurers genuinely do not like DOI complaints because it creates a record. Also, your policy documents themselves should outline the timeline the company is supposed to follow for responding to claims. Pull your declarations page and look for 'claims handling' or 'duties after loss' language. If they've blown past their own stated timelines, that's useful leverage.

  • 18
    spry-swan-970

    Oh man, I felt this post in my chest. Mine dragged on for about three months before I finally got an actual denial letter — and only because I sent a certified letter to their claims department demanding one in writing. The second I did that, suddenly people started calling ME back. Don't just keep calling, put it in writing and send it so there's a paper trail.

  • 17
    tidy-owl-317

    This honestly sounds so exhausting and unfair. You did everything right — you had coverage, you filed promptly, you sent everything they asked for — and they're still putting you through this? I'm so sorry. Please don't let them convince you this is normal or acceptable.

  • 16
    steady-fox-503

    Former adjuster here. What you're describing is unfortunately not uncommon, and some of it is just bad internal communication — but some of it is also a known delay tactic. Here's the thing most people don't know: in almost every state, insurers are required by law to acknowledge your claim promptly AND provide a written explanation if they deny it. That vague voicemail saying 'not approved at this time' almost certainly doesn't satisfy the legal requirement for a proper denial notice. I'd request your full claim file in writing and specifically ask for the denial reason in writing referencing your state's fair claims settlement regulations. Using that language tends to wake people up.

    • 8
      gentle-wolf-180

      One question I'd ask: did anything unusual happen around the time of the accident or when you filed — like were you late on a premium payment, or did you file the claim a long time after the accident happened? Not saying you did anything wrong, just that sometimes there's a technical reason buried in the file that the adjuster never actually explained to you. Might be worth asking them specifically whether the issue is coverage eligibility vs. fault vs. something else entirely, just to narrow it down.

    • 10
      tired-wanderer248

      Appreciate the detailed write-up. Saving this for later.

  • 14
    wise-bison-976

    How are you holding up physically and mentally through all this? I ask because the stress of fighting an insurance company on top of recovering from an accident is genuinely brutal on your body. Make sure you're keeping records of any symptoms — even stress-related ones — and if you haven't already, see a doctor and document everything. I've seen people focus so hard on the car damage that they minimize their own physical experience and then regret it later.

  • 13
    clever-mole-333

    Three steps: 1) Send a certified letter TODAY demanding a written denial with specific reasons. 2) File a complaint with your state's Department of Insurance — Google '[your state] DOI complaint' and it takes maybe 20 minutes. 3) Talk to a personal injury attorney. Most do free consults and they'll tell you fast if you have something worth pursuing. Stop waiting for them to do the right thing on their own. They won't.

  • 11
    wise-beaver-358

    They are absolutely betting that you'll give up or just pay out of pocket. That's the game. Four months of runaround isn't incompetence, it's strategy. The moment you signal that you know your rights or might get a lawyer involved, the whole vibe changes. Don't let them grind you down.

    • 1
      gentle-walker636

      This is exactly what I needed to read today. Thank you.

  • 7
    hearty-tern-016

    Not legal advice, but what you're describing — prolonged delay and a verbal non-explanation — is exactly the fact pattern that prompts attorneys to take a close look at bad faith insurance claims. The denial being oral rather than written is a red flag. Many PI attorneys do free consultations and some will write a demand letter to the insurer just on the strength of a potential case. Might be worth a conversation. Again, not legal advice, just something to consider.

    • 3
      careful-optimist995

      Really glad you posted an update — gives the rest of us some hope.

  • 5
    daring-stoat-131

    I know it doesn't feel like it right now, but the fact that you're asking questions and pushing back already puts you ahead of a lot of people who just accept the runaround and move on. You clearly know something is off here. That instinct is right, and there ARE paths forward — the DOI complaint route alone has resolved a lot of stalled claims for people I know. Keep pushing.